Healthcare Provider Details

I. General information

NPI: 1649598566
Provider Name (Legal Business Name): RUPA POLISETTY SEKHAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 2ND ST NE
WASHINGTON DC
20002-8100
US

IV. Provider business mailing address

700 2ND ST NE
WASHINGTON DC
20002-8100
US

V. Phone/Fax

Practice location:
  • Phone: 202-346-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMD042067
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberD0081984
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number0101260701
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036-138585
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: